What is the immediate first step in neonatal resuscitation?

In neonatal resuscitation, the immediate first step is to ensure the airway is clear. This is critical because a newborn who is not breathing effectively may have an obstructed airway, which can prevent adequate air exchange. By ensuring that the airway is clear, you allow for the possibility of the newborn to breathe and improve oxygenation.

Clearing the airway may involve activities such as positioning the infant correctly, using suction if there are secretions, and ensuring that there are no physical obstructions. Neonates often have a strong reflex to clear their airways on their own once the obstruction is removed or the positioning is corrected, leading to spontaneous breathing.

Other interventions like providing chest compressions, starting positive pressure ventilation, or checking for a pulse are important as well, but they follow the initial step of ensuring the airway is patent. If the airway is not clear, subsequent interventions may not be effective. Therefore, prioritizing airway management is a fundamental principle in neonatal resuscitation.